STEPHANIE DENICE WALCZAK Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057000202

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

DENICE

Last Name

WALCZAK

Business Name

STEPHANIE DENICE WALCZAK

Original Issue Date

08/08/1984

Effective Date

12/02/2013

Expiration Date

12/31/2015

City

NELIGH

State

Zip

68756

County

NEBRASKA

Ever Disciplined

LastModifiedDate

02/08/2016